TY - JOUR
T1 - Efficacy of remotely-delivered cognitive behavioural therapy for obsessive-compulsive disorder: An updated meta-analysis of randomised controlled trials
AU - Salazar de Pablo, Gonzalo
AU - Pascual-Sánchez, Ana
AU - Panchal, Urvashi
AU - Clark, Bruce
AU - Krebs, Georgina
N1 - Funding Information:
Dr Salazar de Pablo and Dr Pascual-Sánchez are supported by the Alicia Koplowitz Foundation . This study presents independent research part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London .
Publisher Copyright:
© 2022 The Author(s)
PY - 2023/2/1
Y1 - 2023/2/1
N2 - Introduction: Despite remotely-delivered cognitive behavioural therapy (CBT) being an emerging field, the evidence of its efficacy in obsessive-compulsive disorder (OCD) is limited. We aimed to estimate the efficacy of remotely-delivered CBT for OCD, compared to face-to-face CBT and non-CBT control conditions. Methods: Randomised clinical trials (RCTs) identified through a systematic literature search of PubMed, Ovid/PsychINFO and Web of Science until 21/06/2021. Eligible studies included individuals with OCD evaluating at least one form of remotely-delivered CBT versus a control condition. Random-effects meta-analyses, sub-analyses, meta-regressions, heterogeneity analyses, publication bias assessment and quality assessment. Results: Twenty-two RCTs were included (n = 1796, mean age = 27.7 years, females = 59.1 %). Remotely-delivered CBT was more efficacious than non-CBT control conditions for OCD symptoms (g = 0.936 95 % CI = 0.597-1.275, p < .001), depressive symptoms (g = 0.358, 95 % CI = 0.125-0.590, p = .003) and anxiety symptoms (g = 0.468, 95 % CI = 0.135-0.800, p = .006). There were no significant differences in efficacy between remotely-delivered CBT and face-to-face CBT for OCD symptoms (g = −0.104 95 % CI = −0.391-0.184, p = .479), depressive symptoms (g = 0.138, 95 % CI = −0.044-0.320, p = .138), anxiety symptoms (g = 0.166, 95 % CI = −0.456-0.780, p = .601) or quality of life (g = 0.057, 95 % CI = −0.178-0.292, p = .489). Higher baseline severity of OCD symptoms was associated with a lower efficacy of remotely-delivered CBT compared to face-to-face CBT (β = −0.092, p = .036). The quality of the included studies was mostly identified as “low risk of bias” (45.5 %) or “some concerns” (45.5 %). Limitations: Heterogeneity and limited evidence for some outcomes. Conclusions: Remotely-delivered CBT appears efficacious in reducing OCD symptoms and other relevant outcomes and is therefore a viable option for increasing treatment access. Preliminary evidence suggests some individuals with severe OCD may benefit more from face-to-face than remotely-delivered CBT.
AB - Introduction: Despite remotely-delivered cognitive behavioural therapy (CBT) being an emerging field, the evidence of its efficacy in obsessive-compulsive disorder (OCD) is limited. We aimed to estimate the efficacy of remotely-delivered CBT for OCD, compared to face-to-face CBT and non-CBT control conditions. Methods: Randomised clinical trials (RCTs) identified through a systematic literature search of PubMed, Ovid/PsychINFO and Web of Science until 21/06/2021. Eligible studies included individuals with OCD evaluating at least one form of remotely-delivered CBT versus a control condition. Random-effects meta-analyses, sub-analyses, meta-regressions, heterogeneity analyses, publication bias assessment and quality assessment. Results: Twenty-two RCTs were included (n = 1796, mean age = 27.7 years, females = 59.1 %). Remotely-delivered CBT was more efficacious than non-CBT control conditions for OCD symptoms (g = 0.936 95 % CI = 0.597-1.275, p < .001), depressive symptoms (g = 0.358, 95 % CI = 0.125-0.590, p = .003) and anxiety symptoms (g = 0.468, 95 % CI = 0.135-0.800, p = .006). There were no significant differences in efficacy between remotely-delivered CBT and face-to-face CBT for OCD symptoms (g = −0.104 95 % CI = −0.391-0.184, p = .479), depressive symptoms (g = 0.138, 95 % CI = −0.044-0.320, p = .138), anxiety symptoms (g = 0.166, 95 % CI = −0.456-0.780, p = .601) or quality of life (g = 0.057, 95 % CI = −0.178-0.292, p = .489). Higher baseline severity of OCD symptoms was associated with a lower efficacy of remotely-delivered CBT compared to face-to-face CBT (β = −0.092, p = .036). The quality of the included studies was mostly identified as “low risk of bias” (45.5 %) or “some concerns” (45.5 %). Limitations: Heterogeneity and limited evidence for some outcomes. Conclusions: Remotely-delivered CBT appears efficacious in reducing OCD symptoms and other relevant outcomes and is therefore a viable option for increasing treatment access. Preliminary evidence suggests some individuals with severe OCD may benefit more from face-to-face than remotely-delivered CBT.
UR - http://www.scopus.com/inward/record.url?scp=85143379730&partnerID=8YFLogxK
U2 - 10.1016/j.jad.2022.11.007
DO - 10.1016/j.jad.2022.11.007
M3 - Review article
SN - 0165-0327
VL - 322
SP - 289
EP - 299
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -